Rhode Island College professor says awareness of autism is growing

Thursday

Mar 27, 2014 at 9:38 PM

PROVIDENCE, R.I. — In the 1980s and ’90s something like 75 percent to 80 percent of children diagnosed as being autistic were thought to have an intellectual disability, but the data used to reach that conclusion...

By Thomas J. Morgan

PROVIDENCE, R.I. — In the 1980s and ’90s something like 75 percent to 80 percent of children diagnosed as being autistic were thought to have an intellectual disability, but the data used to reach that conclusion were found to be flawed, according to a Rhode Island expert on the subject.

Paul LaCava, who heads a graduate-level program in autism studies at Rhode Island College, said Thursday that people in the field gradually began to realize that there were children with autism “who were very able.”

When researchers reviewed the data, LaCava said, “They found lots of flaws. There were no real heavy statistics behind it. It was not just this image of a child who didn’t want to socialize, to interact with others. The new studies showed the kids, the 8-year-olds — the majority did not have an intellectual disability. That is very interesting to me.”

LaCava has been a member of the RIC faculty for five years. His program grants a certificate of graduate study in autism education. So far 54 students have graduated, and many have stayed in Rhode Island to work in the field, he said. LaCava also teaches courses in special education.

The new finding by federal health officials that the number of American children with autism has risen to 1 in 68 is certainly in part due to a changing definition of what constitutes autism, LaCava said.

That definition has undergone not just one, but several evolutions in the last three decades, he said, and the diagnosis is now known as autism spectrum disorder. The whole field was revamped in 2013, he said, when the latest Diagnostic and Statistical Manual for Mental Disorders was published. That’s the standard national handbook for psychiatric and psychological disorders.

LaCava said the numbers have grown because of “more awareness by schools and family and the broadening of the spectrum to include a wide range of manifestations.” Only two years ago, he said, it was considered that 1 child in 88 could be diagnosed as having the disorder.

He cautioned, however, that such studies are by definition some years behind the present. The current definition and conclusion is based on statistics gathered in 2010, and from only 11 states, so there may well be further adjustments in the future.

Is 1 in 68 the true number?

“That’s a very difficult question to answer,” he said. “The bottom line is there are many more kids identified with autism today, and how we train teachers and other personnel to work with them and support their families from early intervention through adulthood is the focus.”

But, he added, “In my work in schools over the last 20 years there really does seem to be an increase in the numbers. Without a doubt, a couple of decades ago, there may have been kids with autism who had other diagnoses, say a behavior disorder or intellectual disability. I’d like to think we are much better at screening and diagnosing appropriately. You have very passionate folks involved. Is it an epidemic on one hand? No. It’s an artifact of how we do business in diagnosing. It’s a very nuanced and complex question. In the news, almost monthly there’s another story about a correlation found between, say, fathers over the age of 45 and an increase in autism, or air pollution, or lead — all kinds of correlations have been found, and risk factors, but still the answer hasn’t happened. Clearly genetics is a bountiful area. Hundreds of genes may be involved. The environmental piece is still hanging out there. Some families believe autism was caused by their child getting a vaccination. They observe their child change before their eyes. Those anecdotal stories are very powerful. Science is still trying to catch up and give the definitive answers.”

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